A Case of Cerebrospinal Fluid Leak in a Patient With Pneumococcal Meningitis and Rhinorrhea

Pneumococcal meningitis is a relatively common condition in the United States. Patients often present with an intense headache and may have accompanying nausea and vomiting, altered mental status, and hearing loss, among other symptoms. A primary concern for a patient with pneumococcal meningitis is the status of their immune system. Cases typically occur in individuals who are immunocompromised and who are more susceptible to bacterial penetration of their central nervous system. Our patient with pneumococcal meningitis proved to be immunocompetent, prompting our curiosity in determining the cause of his illness. A thorough history revealed the origin of his illness: a long-standing cerebrospinal fluid leak.